According to “The Gap,” published Thursday, there’s a shortage of 7 million affordable and available rental homes for extremely low-income renters, defined as people living at or below the federal poverty line, or making 30 percent of their area’s median income. Put another way, the report says, “only 37 affordable and available homes exist for every 100 extremely low-income residents”—the largest shortage for any income group.

The dearth of affordable housing forces a majority of country’s 11 million extremely low-income residents into rentals they can’t afford. The group's research found that 71 percent of those renters are “severely housing cost-burdened,” meaning they spend more than half of their total income on rent and utilities. That leaves little money for other expenses, including groceries, child care or unexpected medical bills.

The report notes that the poorest renters, with the most severe cost-burden, are "more than twice as likely to fall behind on their rent, and be threatened with eviction, than poor renters with no cost burden."

That financial stress coupled with housing instability can wreak havoc on a family’s health and well-being. “Cost-burdened adults are more likely to cut back on needed prescription medications or health-care treatments,” the report says.

Negative health effects can trickle down to the children of burdened adults, who score lower on cognitive testing than their peers with stable housing. Frequent moving can disrupt education and impact academic achievement, the report notes, echoing findings in a recent study on homelessness among students in New York City.

Every state in the country has a shortage of affordable housing, ranging from a lack of 5,799 rental homes in Wyoming to more than a million in California. Poor renters have the hardest time finding housing in Nevada (19 affordable and available rental homes per 100 extremely low-income households), California (22), Arizona (25), Florida (26) and Oregon (28) also did not have much availability. Even the states with the greatest supply—Wyoming (66), Mississippi (64), Alabama (62), West Virginia (61) and Arkansas (56)—still don't have enough available rental places.

The income disparities stretch across age and racial lines. Nearly half—48 percent—of those 11 million extremely low-income residents are seniors or disabled, while 44 percent work, go to school or are single-adult caregivers. Poverty rates are higher among Native American (38 percent), black (35 percent) and Hispanic (28 percent) households than white renters (22 percent).

To combat the problem, researchers suggest rehab and renovation of public housing units, expansion and reform of the low-income housing tax credit program and a “significant and sustained federal commitment to affordable housing programs,” including a “large investment” in the national Housing Trust Fund.

At least some of those recommendations contrast sharply with Trump administration policy priorities. The report comes days after the release of the White House's budget proposal, which includes among other things significant cuts to existing public housing.

“The administration callously disregards its responsibility to the millions of households living in deteriorating public housing and to low-income people and communities working to recover and rebuild after disasters by eliminating critical resources for public housing, rental housing construction and community development,” Yental said in a statement. “This is a cruel and unconscionable budget proposal, and it should be soundly rejected by Congress.”

Kate Elizabeth Queram is a Staff Correspondent for Route Fifty and is based in Washington, D.C.